Medical Oncology

, 34:177 | Cite as

Pre-treatment carcinoembryonic antigen and outcome of patients with rectal cancer receiving neo-adjuvant chemo-radiation and surgical resection: a systematic review and meta-analysis

  • Giuseppe Colloca
  • Antonella Venturino
  • Pasquale Vitucci
Review Article


Neo-adjuvant chemo-radiation is the standard of care for patients with locally advanced rectal carcinoma. The aim of the present paper is to evaluate the relationship of the baseline serologic concentration of the carcinoembryonic antigen with the outcome. Data sources included MEDLINE and Web of Science databases. A systematic search of the databases by a predefined criterion has been conducted. Chemo-radiation followed by surgical resection of rectal tumors was the intervention of interest. From selected studies, the relationships between carcinoembryonic antigen and pathologic complete response, disease-free survival and overall survival were assessed. Carcinoembryonic antigen correlated significantly and inversely with the rate of pathologic complete responses (OR 2.00). Similar to this relationship, a low baseline carcinoembryonic antigen concentration was associated with a better disease-free survival (OR 1.88) and a better overall survival (OR 1.85). Heterogeneity of studies and publication bias were considerable in evaluating the relationship of baseline carcinoembryonic antigen and pathologic complete response. Baseline carcinoembryonic antigen should be regarded as a predictor of outcome of patients undergoing neo-adjuvant chemo-radiation. A calibration of the cutoff value from 5 to 3 ng/ml appears more appropriate to this patient population and should be evaluated in prospective trials.


Carcinoembryonic antigen Rectal cancer Chemo-radiation Prognosis 


Compliance with ethical standards

Conflict of interest


Ethical approval

This article does not contain any studies with human participants performed by any of the authors.


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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Oncology, G. Borea HospitalSanremoItaly
  2. 2.Department of RadiotherapyOspedali RiunitiAnconaItaly

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